Use of fresh osteochondral allograft in repair of distal femur after trauma

Abstract

Preserving the ability to maintain an active lifestyle is a major concern in the reconstruction of the knee in young patients. for the healthy individual who desires to maintain a relatively active lifestyle, fresh osteochondral allografts may serve as an alternative to total joint reconstruction. The use of fresh allografts is  primarily indicated in the patient suffering from a traumatic loss of articular seg- ments, who is too young or active for arthroplasty. In addition, fresh osteochon- dral allografts have a number of advantages over arthroplasty such as providing  surgeons with a source of large grafts that can be ftted to replace osteochondral defects and cover the majority or entirety of articular surfaces without any donor site morbidity. In this case, a young, active patient lost a 7 x 8 cm portion of their  distal femur, including a large portion of the articulating surface. Using a fresh os- teochondral allograft, harvested within 24 hours of donor death, a segment was  ftted to match bony apposition, articular congruity, and congruity with the femoral notch and affxed with four partially threaded cancellous screws. Joint function was restored with the allograft in place, allowing the patient to delay the need for a total joint replacement.